A Medicare formulary is a list of prescription drugs covered by a particular Medicare Prescription Plan. The Medicare Prescription Drug Benefit, known as Medicare Part D, subsidizes the cost of prescription drugs for Medicare recipients.
Each Medicare Prescription Plan has its own formulary. Formularies are generally organized into tiers reflecting the required co-payment. The tiers range from the lowest cost generic drugs to preferred drugs, to the highest cost non-preferred and specialty drugs. Plans can revise their list of covered drugs during the year, but they must provide at least 60 days notice to affected persons. If a prescribed medication is not on a plan's formulary, the patient or the health care provider can contact theMedicare drug plan to request an exception.